Active NPI
Teresa Wagner, R.D., L.D.
- Registered Dietitian
- Saint Paul, MN
National Provider Identifier
1770969750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 3574
- Practice address
- 45 Snelling Ave N
Saint Paul, MN 55104-6842 - Phone
- (651) 699-3438
- NPI assigned
- Aug 3, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 3574 | MN | Primary |
Addresses
Primary practice location
45 Snelling Ave N
Saint Paul, MN 55104-6842
Mailing address
11056 Eagle View Blvd
Woodbury, MN 55129-5223
Phone (651) 387-1873
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nutritional Weight & Wellness, Inc. | Current | Accepting new patients | |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
Locations
121 Washington Ave N
Fl 2
Minneapolis, MN 55401
Phone (302) 386-3653
45 Snelling Ave N
Saint Paul, MN 55104
Phone (651) 326-5650
1605 Queens Dr
Ste 104
Woodbury, MN 55125
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Nutritionist
- Saint Paul, MN
- NPI 1700024890
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438560000000",
"number": "1770969750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11056 EAGLE VIEW BLVD",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551295223",
"telephone_number": "651-387-1873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 SNELLING AVE N",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551046842",
"telephone_number": "651-699-3438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "TERESA",
"credential": "R.D., L.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-03",
"last_updated": "2015-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MN",
"license": "3574",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.